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An elective is the highlight of our medical degree - seen as an opportunity to put what you’ve learnt over the past five or six years into practice in a new environment, preferably warmer than the UK. Diﬀerent people, diﬀerent practices, diﬀerent you?
When considering where to go on an elective, some may fail to realise the implications of where they select. It is vital to consider language and resources as we enter a country that may struggle with equipment and staﬃng.
As medical students, we are all aware of ethics and the implications of our actions. Electives should also be considered in accordance with the four pillars of ethics: Autonomy, Non-maleficence, Beneficence and Justice.
Autonomy is the right of the patient to make their own decision regarding treatment. In developing countries, there may be a level of gender inequality which one may not see in the United Kingdom. For example, consider how you would react to a patient’s family making the decision and obstructing patient Autonomy. In this case, communication and confidentiality is key to putting the patient first. It is also important to respect different cultural views and being aware of these prior to your elective.
Non-maleficence is to do no harm. Being abroad may seem like a place to experiment and venture into lands of the unknown regarding medicine, but as with practising in the UK, it is always crucial to work within your competency. To work in a country which may lack resources is an intricate task and a lack of understanding can result in mistakes with unsolvable consequences.
Beneficence is the act of working with the best interests of the patient in mind. Whilst in a warm, sunny country, it may be easy to forget the reason you are visiting. Again, competency and communication are vital in working with patients, as simple reassurances can make all the difference.
Last but not least, Justice is the act of treating everyone equally. Sadly, discrimination against minorities may be seen more commonly in a developing country, with doctors and nurses refusing to treat individuals from certain races, religions or culture. In this case, a student has no right to join in. In these situations, it would be appropriate to contact your medical school, supervisor or the BMA.
To summarise, here are a few points to remember:
In conclusion, an elective is a great opportunity to practice clinical skills whilst exploring a new culture and learning in an environment with varying resources. It is meant to be a fun learning experience which will be even more enjoyable if you stay within your competency and know where to seek help if needed.
Sophia Mohammed is MSC Representative for St Andrews and Representative to the BMA International Committee
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